Training for post bariatric surgery clients
I have a client who went through the sleeve gastrectomy just over 2 months ago, and she's recently been cleared for more strenous exercise, so I've put her on a strength routine that she does 3 times/week. She's also doing a couch25k program, with 1 active rest day in the week. Diet is used as directed, at ~650 calories per day. She's doing everything right, but still experiencing a stall in weight loss. Any suggestions for types and frequency/duration of training? Any tips on mixing it with nutrition?
at 2 months after that surgery, I would not change anything. Chances are that her weight loss will pick up again in a short while.
It is generally a good idea, though, to modify her routine from time to time and include circuit type training such as the peripheral heart action system as it has a strong cardio component in the strength routine.
Having trained multiple clients coming off of bariatric & similar surgeries, as well as those trying to avoid such surgeries, a stall in weight loss at this stage is very common. There are many factors for this type of extreme weight loss, but let me list a few.
1) If, like most bariatric candidates, your client is transitioning from a sedentary lifestyle to a regular fitness routine, they will add muscle more quickly than they are burning bodyfat. Since most patients of these surgeries (statistically) do not add exercise until months or years post-op, some doctors & nurses are unaware of the difference this can mean in terms of immediate weight loss. Other forms of measurement may be a good way to reinforce that the changes are working, even when the scale isn't budging. (When possible, use Body Composition Assessment, girth measurements, clothing size changes & gains in strength & mobility)
2) Remember that for glycogen replacement, the body stores water after heavy workouts like weightlifting or intense cardio. In a heavier person, this water retention can boost the scale by several pounds for up to 48 hours after exercise.
3) The client's body is fighting to maintain its homeostasis. Its internal scale has been set at a certain amount of bodyweight for a long time. The hormonal mechanisms in the body do not 'want' to lose too much weight at one time. This is a protection mechanism and a sign of improving health. Most of my gastric bypass clients have experienced several plateaus in overall weight loss. It typically occurs every 25-35 pounds or 9-12 weeks. Each time, the client was still seeing other changes, and later Body Composition Assessments proved that metabolic changes were happening all along. When these plateaus occur, the client can become very discouraged, very quickly. Of course it's good to check in with their habits, but remind them of the good progress that has already been made. Keep the most positive attitude you can! It will be contagious & help them to avoid "falling off the wagon".
I'd be more than happy to discuss this topic further with you, and even have client testimonials which could help your client to see that she is not alone. Message me here anytime.